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Prospective observational cohort study of symptom control prediction in paediatric asthma by using the Royal College of Physicians three questions.pdf (761.23 kB)

Prospective observational cohort study of symptom control prediction in paediatric asthma by using the Royal College of Physicians three questions.

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journal contribution
posted on 2019-09-24, 13:41 authored by Glen Andrews, David K. H. Lo, Matthew Richardson, Andrew Wilson, Erol A. Gaillard
The Royal College of Physicians three questions (RCP3Q) is widely used for assessing asthma control within primary care in the UK, despite limited evidence in children. This study compared the RCP3Q as a tool for assessing asthma control in children (5-16 years) against the validated Asthma Control Test (ACT), Childhood Asthma Control Test (C-ACT), and Mini-Paediatric Quality of Life Questionnaire (MiniPAQLQ). We conducted a prospective observational cohort study involving children from eight primary care practices in Leicestershire. Children with doctor diagnosed asthma, or receiving regular asthma medication, were invited to participate. A total of 319 participants completed the MiniPAQLQ and the C-ACT/ACT questionnaires, before RCP3Q responses were collected as part of their routine asthma review conducted immediately afterwards. RCP3Q sensitivity for detecting uncontrolled asthma ranged from 43-60% and specificity from 80-82%. Using an RCP3Q score ≥2 to predict uncontrolled asthma and an RCP3Q score of zero to predict well-controlled asthma resulted in 10% of participants misclassified as uncontrolled and 8% as well-controlled, respectively. Using an RCP3Q threshold score of ≥1 resulted in 25% of participants being misclassified as uncontrolled. Our data suggests limited utility of the RCP3Q to assess asthma control in children. Alternative indicators of asthma control, such as the validated Asthma Control Test and the Children's Asthma Control Test should be considered instead.


We are grateful to Lesley Danvers for her significant role in arranging and running recruitment clinics at each practice. We are also grateful to staff at each GP practice for their support and use of resources in the recruitment of patients and collection of data for this study. We are particularly grateful to all the children and their families who gave up their time to participate in this study. The data in this study was collected as part of the CHAMPIONS study which is funded jointly by Circassia Pharmaceuticals and the Midlands Asthma and Allergy Research Association (MAARA). Circassia also provided NIOX VERO tests and the loan of the NIOX VERO devices for the CHAMPIONS study. The funders were not involved with the data analysis, interpretation or conclusions drawn from this study.



npj Primary Care Respiratory Medicine, 2018, volume 28, Article number: 39

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/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Infection, Immunity and Inflammation


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npj Primary Care Respiratory Medicine


Nature Research (part of Springer Nature)



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The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.



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